Abstract
This study is designed to determine the effect of collagen membrane (CM) soaked with bone morphogenetic protein-2 (rhBMP-2) for the treatment of peri-implant dehiscence defects. Material and Methods. Three treatment groups were allocated at each defect in 5 dogs: (i) collagenated synthetic bone (OC) and CM soaked with rhBMP-2 (BMP group), (ii) OC and CM soaked with saline (nonBMP group), and (iii) no further treatment (control group). Titanium pins were used to stabilize the membranes in two dogs. Radiographic and histomorphometric analyses were performed 4 weeks later. Results. The median augmented volumes were 4.27 mm3, 6.24 mm3, and 2.75 mm3 in the BMP, nonBMP, and control groups, respectively; the corresponding median first bone-to-implant contact (fBIC) distances were 3.25 mm, 3.08 mm, and 2.56 mm (P > 0.05). The placement of pins (with the BMP and nonBMP groups pooled) significantly improved bone regeneration: the augmented volumes were 17.60 mm3 with pins and 3.68 mm3 without pins (P = 0.024), with corresponding fBIC distances of 2.25 mm and 3.31 mm, respectively (P < 0.001). Conclusions. The addition of rhBMP-2 to CM failed to improve bone regeneration of peri-implant dehiscence defects compared to using an unsoaked CM after 4 weeks. However, the stabilization of CMs using pins positively influenced the outcomes.
Highlights
Guided bone regeneration (GBR) using collagen membrane (CM) is a well-documented treatment modality for augmenting localized peri-implant bone defects, with many clinical and preclinical studies demonstrating that exposed implant surfaces can be successfully augmented [1,2,3,4,5]
RhBMP-2 was combined with the bone-substitute material in all of these studies; this resulted in successful treatment outcomes and superiority compared to control groups, the outcomes were to some extent controversial and limited by the clinical applicability of soaking bone-substitute materials
This study has revealed that (i) the addition of rhBMP2 to a CM does not significantly improve peri-implant bone regeneration and (ii) fixation of the CM using pins significantly increases bone regeneration compared to using a CM without pins
Summary
Guided bone regeneration (GBR) using collagen membrane (CM) is a well-documented treatment modality for augmenting localized peri-implant bone defects, with many clinical and preclinical studies demonstrating that exposed implant surfaces can be successfully augmented [1,2,3,4,5]. This type of resorbable membrane appears to result in insufficient space maintenance, which is reportedly due to the pressure from the covering flap resulting in membrane collapse [3, 6]. RhBMP-2 was combined with the bone-substitute material in all of these studies; this resulted in successful treatment outcomes and superiority compared to control groups, the outcomes were to some extent controversial and limited by the clinical applicability of soaking bone-substitute materials
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